MRI of right foot without contrast
There is a markedly dysmorphic appearance of the first metatarsal related to the presence of a longitudinal epiphyseal bracket along its medial aspect. There is osseous fusion of the epiphysis and diaphysis distally, with open physes proximally and medially. In addition, there is an ovoid focus of calcification medial to the distal aspect of the first metatarsal. This appears separate to the bracket and in keeping with a hypoplastic metatarsal related to mild preaxial polydactyly. There is a dysmorphic, trapezoid morphology to the metatarsal, with its apex directed laterally.
The medial cuneiform is enlarged and dysmorphic in appearance with elongated medial process and a V-shaped articulation with the first metatarsal. Middle cuneiform is normal in size. The base of the second metatarsal is broad and overhangs the middle cuneiform laterally. There is apex lateral curvature of the second metatarsal.
Subjectively there is secondary forefoot varus as is expected with a longitudinal epiphyseal bracket however this would be better assessed and quantified with standing radiographs.
A small amount of marrow edema is noted at the base of the proximal phalanx of the hallux. There is no fracture line seen. This is in keeping with stress response and may be related to altered biomechanics.
The soft tissues are normal in appearance. There is no evidence of tenosynovitis. There is no joint effusion.